Surviving the dark days of winter

It’s that time of year again when we set our clocks back one hour. This seemingly inconsequential action acts as a harbinger of things to come that cause stress for many of us. Starting tomorrow we get to look forward to fewer hours of daylight, cold temperatures, seeing our families and possibly having the responsibility of holding holiday get-togethers in our own homes, spending money on gifts and having to go shopping, raking leaves, and winterizing our cars and homes. It’s a lot to prepare for, and what makes it worse, is that our bodies don’t particularly like this time of year, which doesn’t make dealing with this stress any easier.

We have all heard the term “Seasonal Affective Disorder” or more casually seasonal depression. But what exactly is SAD? If the acronym doesn’t give it away for you, the The Mayo Clinic explains Seasonal Affective Disorder as, “…a type of depression that's related to changes in seasons — SAD begins and ends at about the same times every year. If you're like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. Less often, SAD causes depression in the spring or early summer.” The Mayo Clinic goes on to explain that symptoms include oversleeping, weight gain, tiredness and loss of energy, and a desire to eat foods high in carbohydrates.

I spent some time reviewing literature online to find out what causes Seasonal Affective Disorder. The short answer is that no one knows, or at least, none of the researchers that study Seasonal Affective Disorder can fully agree on what actually causes seasonal mood changes. The National Institute on Mental Health (NIMH) sums up the biological indicators of people at risk for experiencing Seasonal Affective Disorder. NIMH indicates that people who experience SAD may have trouble regulating serotonin. What is serotonin? Well apparently it does a lot of things for our body, but for the sake of this post, we will define it simply as a chemical in the body that stabilizes our mood. The NIMH does on to explain that people who suffer from SAD might also produce unusually high levels of melatonin. Melatonin is a chemical our body that makes us sleepy. Finally, NIHM says that people who suffer from SAD may produce less vitamin D. Vitamin D is naturally acquired by humans by being in direct contact with sunlight.

While I do not regularly do research, through my clinical work in healthcare settings, I have seen a lot of patients, and in treating patients, especially for mental health issues, rarely is there just one cause for the presenting problem. Typically, a number of factors, or symptoms, work together to create a problem. My theory is that, we can’t just assume that SAD is caused by one thing, but likely is determined by multiple biological factors, along with social and behavioral factors. Follow me down this path: Biologically, some of us may be biologically at higher risk for depression, then we add the lack of sunlight and cold temperatures, then the stress of having busier schedules, knowing we have to spend more money than usual during the holiday season, we end up eating more, sleeping more, not getting out an socializing as frequently due to our lack of energy… we have a created the perfect storm to cause seasonal depression.

So what do we do to treat Seasonal Affective Disorder? The biological factors can be treated with medication. Melatonin and vitamin D can be bought over the counter (speak with your physician before starting any medication, including over the counter medication). To address serotonin issues, you can speak with your physician about starting you on an antidepressant. And what do we do to treat SAD behaviorally? A lot of times we tell ourselves we just need to “tough it out.” While it’s an option, sometimes “toughing it out” doesn’t just naturally work for everyone. There are a ton of recommendations out there.

The NIMH has a ton of great recommendations of how to treat Seasonal Affective Disorder. During my research, the most commonly recommended treatment is the use of “light therapy.” Basically, light therapy is a home therapy where during a specific time of day, you shine a special lamp in your face for a specific amount of time. I have never done this, but it’s certainly seems to be a common recommendation and scientifically makes sense to me. Website The Cut made a nice little list of some light therapy lamps that they recommend that are available for purchase on Amazon. However, you should speak with your doctor before you start light therapy, as it can cause sleep issues if you do not do it at the right times or if you are doing it too frequently.

The NIMH also mentions psychotherapy as treatment for SAD. Shameless plug: If you are interested in getting over your seasonal depression, I’d love to help you. If you live in the St. Louis area and would like to speak with me about your seasonal depression, you can call me at 314-492-4242 to discuss your situation with me. There’s also lots of other great area mental health clinicians that can help you out with the issue. If you are looking for someone to help you, you can search in your region using Psychology Today.

Other recommendations for treating SAD include healthy lifestyle choices: getting an appropriate amount of sleep at appropriate times, exercising regularly, using coping skills to manage your stress, eating healthy foods, and regular socialization, and following your treatment plans. I want to make some recommendations of what you can do to overcome seasonal depression. DISCLAIMER: Please consult with your physician before making any major lifestyle changes.

  1. Get regular sleep and do it at night. Try to stay on a sleep schedule as much as possible. Sticking to a regular bedtime and getting 7-8 hours of sleep each night is important. Sleeping regularly is healthy and therapeutic for our bodies and minds. There is a lot of evidence that people who do not sleep regularly suffer from a number of health issues. You can read more about these issues here.

  2. Exercise, to some extent, daily. Find an exercise routine that works for you. It might be jogging, yoga, an intense aerobics class, or taking a brisk walk. During the winter, I recommend doing some exercise outside during daylight hours to hit two birds with one stone. You are both exercising and getting that much needed time in the sun that becomes more and more sparse as the winter goes on.

  3. Socialize. Take time to socialize with other people. It’s an incredibly healthy thing to do, and becomes harder and harder as the winter goes on due to our tendency to stay in more from the cold weather and lack of energy, and due to family obligations, can be harder to make times to be out in the community. I recommend going out for a nice dinner at a restaurant that you don’t typically go to with a friend you haven’t seen in awhile. Don’t be afraid to go somewhere where you might have to dress up a little bit. I believe that dressing up, especially if you do not do it regularly, can provide an ego boost, which can be very beneficial when, during the winter months, we tend to have lower self esteem than normal.

  4. Keep active with a hobby or two. Hobbies are coping mechanisms for stress and depression. I can’t tell you what your hobbies are, but I can tell you that having a hobby that you can practice regularly will take up some of that time that you would otherwise spend in front of the TV, computer, smartphone, or sleeping. On top of practicing a hobby, I recommend putting aside time to volunteer during the holiday season. While it might be stereotypical to suggest this, I, personally, cannot recommend enough the therapeutic benefit to helping others through the act of volunteering. Doing good for others is a something that happy people do.

  5. Eat a healthy diet. It’s no secret that poor diet causes major health issues. A poor diet can also affect our mental health. Dr. Eva Selhub wrote this concise article for the Harvard Medical School Health Blog outlining studies that show the relationship between poor diet and increased depression. Since, during the winter months, our bodies naturally crave unhealthy foods, if we eat these unhealthy foods too often, we are at higher risk for experiencing depressive symptoms.

  6. Make a treatment plan to help you to stay on task with the healthy choices that you have made. This one kind of stands alone, in that, it is a tool you create to hold you accountable to all of the healthy choices you plan to make. Some people are able to internalize a treatment plan and stick to it. Some people… but not most. I, personally, write my own informal treatment plan on paper, and keep it with me in my computer bag, sticking out, so that I remember to look at it regularly. Some people can make their own treatment plan, but a lot of people find the process of creating a treatment plan to be overwhelming and need some help doing it. I would like to share with you an example of a treatment plan that I created for myself. Note: This is not an actual clinical treatment plan and is only being used as an example of how the recommended treatment for SAD can be adapted to an individual along with a brief explanation to why these activities work. If you pursue support creating a clinical treatment plan for SAD, your plan will typical have more depth to it.

    Goal: Scott will overcome seasonal depression.

    Intervention: Scott will make healthy lifestyle choices.

    1. Cook dinner at home 6 nights per week. For me, I fall into unhealthy eating habits due to having a busy schedule. If I make it a habit to cook dinner instead of grab something on the way home, I tend to eat healthier foods.

    2. Take my dog for a walk every day immediately after work. While it isn’t rigorous exercise, it’s something. I get the benefit of getting some of that rare sunlight. Plus, my dog is happier when he gets his exercise and social time.

    3. Do strength building exercise at least 3 days per week for 30 minutes. I have made it a habit to do strength building exercises every time I go in my basement, which is typically about 3 times per week to do laundry. For just over $50, I bought two sets of resistance bands from amazon and a fitness hook for the ceiling in my basement so that I may benefit from strength exercises at a much lower price point than buying a weight set or even getting a gym membership.

    4. Record a song. I have a home music studio and have some ability to play multiple instruments (some better than others). I bought a fairly nice piece of recording equipment over the summer and I haven’t had much time to use it. That’s kind of a lie. I have had time to use it much, I just haven’t made time to use it. I’d like to spend 6 hours per week playing music, and 1 hour of that week specifically geared towards learning to use this new piece of equipment I bought. If I play music 6 hours per week, every week from November through February, that’s 96 hours dedicated to my hobby, and learning a new skill. 6 hours a week seems like a lot, but most people probably spend way more time than that on Netflix. It’s less than an hour a day, and on weekends, I can easily work in 3 hours very easily.

    5. Read two books throughout the winter. I have a bad habit of falling asleep with movies on. It’s is really the only time I put aside for movies, unless I go out to the theater to see a movie. I have heard time and time again, it is bad for sleep to watch movies or television before you go to sleep, and that it is not good for you to fall asleep with the television on. I just started reading The Ultimate Hitchhiker’s Guide to the Galaxy. (I actually read the original book around the time that the film came out in 2005, but never read any of the other books in the series.) I plan to finish that and read one other book before March 1. I think I can achieve this simply by turning off the television and picking up a book instead.

This is not all of my personal treatment plan, but it does give you an idea of the types of things you can do to put into a treatment plan. If creating a treatment plan is something you are interested in learning more about and creating for yourself, I would be happy to speak with you and help you with it. You can call me at 314-492-4242 (sorry about the second shameless plug).

If you have any suggestions for how you treat your seasonal depression or Seasonal Affective Disorder, I would love for you to share in the comments.

I hope that this information is helpful in helping you to combat seasonal depression.

Don’t Panic,